Hybrid Clinical Appeals Specialist II

Mayo Career Site UK; Rochester (MN); Hybride; USD 68 000 - 90 000; Plein temps

Résumé du poste

Mayo Clinic is seeking a hybrid-eligible reviewer to work within 100 miles of Mayo Clinic campuses. The role involves reviewing clinically related denials, payer audits, and payer correspondence, and preparing appeals or audit responses.

You will apply clinical expertise and critical thinking to evaluate medical records against criteria and contracts, and collaborate with revenue cycle, case management and practice stakeholders to defend denials and prevent recurrence.

Responsabilités

• Review clinically related denials, payer audits and payer correspondence.
• Prepare relevant appeal submissions or audit responses.
• Apply clinical expertise and critical thinking to evaluate medical records against criteria and contract requirements.
• Liaise with revenue cycle, case management and practice stakeholders to defend denials and identify denial prevention opportunities.

Description du poste

Mayo Clinic is seeking a hybrid-eligible reviewer to work within 100 miles of Mayo Clinic campuses. The role involves reviewing clinically related denials, payer audits, and payer correspondence, and preparing appeals or audit responses.

You will apply clinical expertise and critical thinking to evaluate medical records against criteria and contracts, and collaborate with revenue cycle, case management and practice stakeholders to defend denials and prevent recurrence.